Coherence Breathing Before Cardiopulmonary Exercise Testing

Acute Effects of Coherence Breathing on Cardiopulmonary Exercise Responses in Recreationally Active Adults: A Randomized Crossover Trial

This randomized crossover trial will examine the acute effects of pre-exercise coherence breathing on cardiopulmonary exercise responses in recreationally active adults. Participants will complete two experimental conditions in randomized order: 5 minutes of guided coherence breathing and 5 minutes of quiet seated spontaneous breathing. Following each condition, participants will perform a standardized treadmill warm-up and a maximal cardiopulmonary exercise test. Outcomes will include oxygen consumption, heart rate, heart rate recovery, perceived exertion, time to completion, and heart rate variability. The findings may help determine whether coherence breathing can serve as an effective autonomic priming strategy before a bout of maximal exercise

Study Overview

• Status: Not yet recruiting
• Conditions: Breathing Rate
• Intervention / Treatment: Behavioral: Coherence Breathing; Behavioral: Spontaneous Breathing

Detailed Description

Slow-paced breathing performed at approximately six breaths per minute has been shown to influence autonomic nervous system activity and heart rate variability. Coherence breathing may improve physiological regulation by enhancing cardiorespiratory synchronization and vagal modulation. However, little is known about whether a brief bout of coherence breathing performed immediately before exercise can influence cardiopulmonary exercise performance. The purpose of this study is to investigate the acute effects of pre-exercise coherence breathing on cardiopulmonary exercise performance and autonomic responses in recreationally active adults. This study will utilize a randomized, counterbalanced crossover design. Recreationally active adults aged 19 to 45 years will complete two experimental conditions in random order separated by a minimum of 48 hours (maximum of 7 days). In one condition, participants will perform 5 minutes of guided coherence breathing using a visual breathing pacer at approximately 6 breaths per minute while seated. In the comparison condition, participants will sit quietly for 5 minutes with spontaneous breathing. Following each condition, participants will complete a standardized treadmill warm-up and a maximal cardiopulmonary exercise test (CPET). Heart rate variability will be assessed during baseline seated rest and during the breathing intervention. Cardiopulmonary variables collected during CPET will include oxygen consumption, heart rate, respiratory responses, and ratings of perceived exertion. Recovery responses over 5 minutes seated include heart rate and blood pressure will also be assessed following exercise.

Findings from this study may improve our understanding of breathing strategies for athletic performance. Specifically, whether slow paced breathing through coherence breathing can serve as a practical autonomic priming strategy before maximal exercise. Moreover, insights from this study may provide insight into the acute interaction between breathing regulation, autonomic function, and exercise responses.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Tamara Rial-Faigenbaum, PhD; Phone Number: 2159878984; Email: trialfai@monmouth.edu
• Study Contact Backup: Name: Jaime Pigman, PhD; Phone Number: 732-749-0160; Email: jpigman@monmouth.edu

Study Locations

• United States
  • New Jersey
    • West Long Branch, New Jersey, United States, 07764
      • Monmouth University Graduate Center, Human Performance Lab, Room 222
      • Contact: Tamara Rial-Faigenbaum, PhD; Phone Number: 2159878984; Email: trialfai@monmouth.edu
      • Contact: Jaime Pigman, PhD; Phone Number: 732-749-0160; Email: jpigman@monmouth.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Adults aged 19 to 45 years.
• Any biological sex.
• Recreationally active, defined as accumulating at least 3 hours per week of moderate-to-vigorous physical activity.
• Able to perform maximal cardiopulmonary exercise testing on a treadmill.
• Able to provide informed consent.
• Cleared for moderate-to-vigorous physical activity based on the PAR-Q+ (or PAR-Q 2023).

Exclusion Criteria:

• Accumulate less than 3 hours per week of moderate-to-vigorous physical activity.
• Presence of a health condition that contraindicates maximal exercise testing, including:

Cardiovascular disease. Pulmonary disease. Metabolic disorders. Neuromuscular disorders. Orthopedic limitations that impair exercise performance.

• Acute illness that would interfere with participation or exercise testing.
• Inability or unwillingness to complete study procedures.
• Inability or unwillingness to provide informed consent.
• Not cleared for moderate-to-vigorous physical activity based on the PAR-Q+ (or PAR-Q+ 2023).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Coherence Breathing; Participants complete 5 minutes of guided coherence breathing	Behavioral: Coherence Breathing; Participants complete 5 minutes of guided coherence breathing which consists or around 6 breathing cycles (5 seconds inhale and 5 seconds exhale); Other Names: slow-paced breathing; resonance breathing
Active Comparator: Spontaneous Breathing; Participants sit quietly for 5 minutes with spontaneous breathing	Behavioral: Spontaneous Breathing; Participants sit quietly for 5 minutes with their regular spontaneous breathing

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peak Oxygen consumption	Peak oxygen consumption measured during the maximal cardiopulmonary exercise test (CPET) using a portable metabolic analyzer (Vo2 Master)	during each maximal exercise test immediately after the breathing condition

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
rating of perceived exertion (RPE)	using the RPE borg scale (from 1-10)	measured at baseline, during the exercise test and after recovery
Heart Rate Recovery	Heart Rate (bpm) immediately after completing the CPET over a period of 5 minutes	difference between peak HR during CPET and HR at minute 1, minute 2 and minute 5 of recovery.
Time to completion of maximal exercise test	total duration of the exercise test since test starts to voluntary termination	during the exercise test
Peak Heart Rate	maximal heart rate achieved during the maximal exercise test	measured during the maximal exercise test

Collaborators and Investigators

• Sponsor: Human Performance Lab of Monmouth University

Publications and helpful links

General Publications

• Laborde S, Allen MS, Borges U, Dosseville F, Hosang TJ, Iskra M, Mosley E, Salvotti C, Spolverato L, Zammit N, Javelle F. Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. Neurosci Biobehav Rev. 2022 Jul;138:104711. doi: 10.1016/j.neubiorev.2022.104711. Epub 2022 May 24.
• Sevoz-Couche C, Laborde S. Heart rate variability and slow-paced breathing:when coherence meets resonance. Neurosci Biobehav Rev. 2022 Apr;135:104576. doi: 10.1016/j.neubiorev.2022.104576. Epub 2022 Feb 12.
• Trinkunas E, Kairiukstiene Z, Trinkunaite M, Poderiene K, Brazdzionyte R, Poderys J. Post-Exercise Controlled Breathing Enhances Cardiovascular Recovery and Autonomic Balance: A Randomised Crossover Study. Medicina (Kaunas). 2026 Feb 3;62(2):318. doi: 10.3390/medicina62020318.

Study record dates

Study Major Dates

• Study Start (Estimated): June 11, 2026
• Primary Completion (Estimated): September 6, 2026
• Study Completion (Estimated): October 6, 2026

Study Registration Dates

• First Submitted: June 10, 2026
• First Submitted That Met QC Criteria: June 10, 2026
• First Posted (Actual): June 16, 2026

Study Record Updates

• Last Update Posted (Actual): June 18, 2026
• Last Update Submitted That Met QC Criteria: June 16, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: breathing; heart rate variability; exercise testing; warm-up; heart rate recovery; slow paced breathing
• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Respiration Disorders; Pathological Conditions, Signs and Symptoms; Respiratory Aspiration
• Other Study ID Numbers: SP2645

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No